Therapeutics - Infectious disease 4

  1. What are the 3rd generation cephalosporins?
    • Ceftriaxone (Rocephin)
    • Ceftazidime (Fortaz)
    • Ceftaxime (Claforan)
    • Cefdinir (Omnicef)
    • Cefditoren (Pivoxil)
    • Cefixime (Suprax)
    • Cefpodoxime (Vantin)
    • (Taztriaxtaxdinir
    • Fixditorpod)
  2. What are the IV 3rd generation cephalosporins?
    • Ceftriaxone (Rocephin)
    • Cefotaxime (Claforan)
    • Ceftazidime (Fortaz)
  3. As you ascend the cephalosporin generations, what change in spectrum occurs?
    Loose Staph activity
  4. Are G+ or G – the primary target for 3rd generation cephalosporins?
  5. What is the spectrum for 3rd generation cephalosporins (charts)?
    • G+: Group A strep, S. penumoniae, Peptostreptococci (4), S. aureus (4)
    • G-: H. flu, N. gon, e. coli, K. pneumonia (4)
  6. Do 3rd generation cephalosporins have good anaerobic activity?
  7. Ceftazidime (3rd gen cephalosporin) compare to ceftriaxone in terms of spectrum in what ways?
    • Less S. aureus and peptostreptococcus (4 vs 8)
    • Better H. flu and N. gon
    • Some pseudomonas (8)
    • Some S. marcescenes (4)
  8. What are the PO 3rd generation cephalosporins?
    • Cefdinir
    • Cefditoren
    • Cefixime
    • Cefpodoxime
  9. What arethe common uses for 3rd generation cephalosporins?
    Community and nosocomial infx (meningitis, pneumonia, cellulitis, sinusitis, otitis, STD)
  10. What is a normal dose for 3rd generation cephalosporins?
    • Ceftriaxone 1-2G IV q 12-24h
    • Cefotaxime 50-75mg/kg IV q6-12h
    • Cefdinir 300-600 mg q12-24
    • Cefditoren 400 mg q12
    • Cefixime 400 mg q24h
    • Cefpodoxime 100-200 q12h
  11. What is a normal dose of Ceftriaxone (3rd gen)?
    1-2G IV q 12-24h
  12. What is a normal dose of Cefotaxime (3rd gen)?
    50-75mg/kg IV q6-12h
  13. What is a normal dose of Cefdinir (3rd gen)?
    300-600 mg q12-24
  14. What is a normal dose of Cefditoren (3rd gen)?
    400 mg q12
  15. What is a normal dose of Cefixime (3rd gen)?
    400 mg q24h
  16. What is a normal dose of Cefpodoxime (3rd gen)?
    100-200 q12h
  17. What is the peak level of Ceftriaxone after 1 gram IV?
    175 ug/mL
  18. What is the peak level of Cefdinir after 300 mg PO?
    1.6 ug/mL
  19. What is the T1/2 of Ceftriaxone?
    8 hours
  20. What is the T1/2 of Cefdinir?
    • 1.7 hours
    • 16 with renal insufficiency
  21. What are the 3rd generation cephalosporins used most for?
  22. You should have to adjust dosing in renal insufficiency for PCNs and Cephalosporins with what exception?
  23. What are the SE for Ceftriaxone?
    Biliary sludge formation(30% biliary excretion)
  24. What are the benefits of Ceftriaxone?
    • Useful for adult meningitis
    • No adjustment for renal insufficiency
  25. Would you use Ceftazidime for Pseudomonas?
    Has been overused, so probably not
  26. Which cephalosporin is useful for pediatric meningitis?
    Cefotaxime (3rd gen)
  27. What are the 4th generation cephalosporins?
    Cefepime (Maxipime)
  28. What is the coverage for Cefepime (Maxipime)?
    • G +: MSSA (4), Good Group A strep, S. pneumonia
    • G-: H. flu, N. gon, E. coli, K. pneumo, E. cloacae, S. marcescenes
    • Very limited pseudomonas (16)
  29. By what route is Cefepime (4th gen) given?
    IV only
  30. How is Cefepime (4th gen) eliminated?
  31. What are the major uses for Cefepime (4th gen)?
    • Neutropenic fever
    • Pseudomonas infx
    • Intra-abdominal infx
    • Meningitis
  32. What is a normal dose for Cefepime (4th gen)?
    1-2 grams Q8-12H IV
  33. What is the 5th generation/Advanced generation cephalospoirin?
    Ceftaroline (Tefaro)
  34. What is the main advantage of Ceftaroline over other cephalosporins?
    • MRSA coverage
    • 1st beta-lactam to have MRSA coverage
    • Use when patients do not respond well to Vanco
  35. What is the primary use of Ceftaroline (5th)?
  36. Would you use Ceftaroline (Teflaro) for gram negative infections?
    No, because it is to broad, choose a more narrow spectrum if possible
  37. What is the spectrum (chart) fo ceftaroline?
    • G +: MSSA, MRSA, Coagulase negative staph, Group A strep, S. pneumonia
    • G -: H. flue, N. gon, E. coli, K. pneumon, E. cloacae, S. marcescenes
  38. What is the route of administration for ceftaroline (Teflaro)?
    IV only
  39. How is ceftaroline (Teflaro, 5th) eliminated?
  40. What are the FDA approvals for Ceftaroline (Teflaro, 5th)?
    • Skin/skin structure infections
    • Community acquired pnseumonia
  41. What is a normal dose of ceftaroline (Teflaro, 5th)?
    600 mg Q12H IV
  42. What is the peak level of Ceftaroline?
    21.3 ug/mL after 600 mg IV
  43. What is the T1/2 for ceftaroline?
    • 2.7
    • No data for ESRD
  44. What are the carbepenems?
    • Imipenem/Cilastatin (Primaxin)
    • Meropenem (Merrem)
    • Doripenem (Doribax)
    • Ertapenem (Invanz)
Card Set
Therapeutics - Infectious disease 4
Therapeutics - Infectious disease